Cleaning and Fortunate

04/01/2011

Good morning! I just finished feeding, cuddling, and rocking Emily. I love waking up to that little girl.

We've been busy around here- getting ready for my parents arrival this Sunday. My parents are flying in and visiting with us for a week. My mom will celebrate her 60th birthday with us while they are here. I had one of Emily's pictures made into a birthday mug as well as a photo book with pictures of her first five months. My mom will love it! We're giving her the third season of Emily of New Moon and going in with my brother to get my mom an i-pad or some other gadget that I am not really familiar with. The thought is that my mom will enjoy it if she has to spend more time in bed as she has days where she doesn't really feel well due to her cancer.

The house is mostly clean. It's picked up but needs dusting vacuuming, there is some laundry that still needs to be done, and bottles that need to be sterilized ( we use glass). We also need to pick up a dust ruffle for the guest room bed and an over the shower caddy for Emily's bathroom. I might also pick up two grown up towels since the ones that go in there are bright green and have monkey heads on them. Yes, if you are an overnight guest in my house you get to use Emily's monkey bathroom.

We have had two warm, sunny days this week and the change in weather has been nice. This meant I needed some warm weather clothes, much to my dismay. While I lost all the baby weight, I think Emily permanently widened my pelvis. Good-bye size 0. Hello size 2. This is the first time in my life that I have had to go up a pant size ( well other than I when I was a kid of course). Even when I was pregnant I wore a size 0 maternity. I haven't really had to shop for pants since I had Emily because I have had to live in sweat pants for the most part because of wound vacs. My wound is right where a pair of paints buttons and wound vac tubing and a skirt would not work. So yes, bigger pants were needed and I kept putting it off. Last night, Scott watched Emily and literally forced me to go shopping. I picked up a pair of capris, a pair of bermuda shorts, and some yoga pants, two blouses, and some t-shirts to replace my old ratty ones. I was hoping to find a skirt, but they were all too short for my liking. I also found Emily two adorable outfits on clearance for next fall/winter. It felt really good to wear something that didn't have elastic.

I was discharged from at home nursing this week. It was pointless. I feel great and the doctor said I was healing beautifully. Let's hope the third time is the charm. It feels weird though. For the first time in over 8 months we don't have medical worries hanging over our heads. We've had the three bouts of preterm labor, three months of bedrest, the bacterial infection, necrotizing fasciitis, seven surgeries, torticollis, plageocephaly, the cardiologist scare, the craniosynostosis scare, infected sutures and now nothing. It all worked out. Emily arrived full term and healthy. They got rid of her bacterial infection before she was symptomatic and eventually found the right antibiotics to get rid of mine. I survived necrotizing fasciitis. Emily's torticollis has been reclassified as very mild and will go away completely in the next few months. Her plageocephaly has been resolved. Her heart murmur was benign and has resolved. She does not have craniosynostosis . Hopefully all of my infected sutures are gone and won't cause anymore problems. We have so much to be thankful for. I'm healthy, Emily's healthy, and it looks like we might actually have a normal summer. We're planning some normal family things- a weekend in San Fransisco, a trip to the beach, a little hiking, trips to the aquarium and zoo. It feels nice.

I actually let myself read a little bit about necrotizing fasciitis the other day. I haven't wanted to read or talk about it since it happened. Yes, I knew a lot about it because of my hospitalization, but hadn't really wanted to discuss it outside of that. I read some other survivor stories. Untreated, it has a mortality rate of 100%. It has to be treated early and aggressively. Even with optimal treatment the mortality rate is as high as 40%. People who have just given birth are at risk because your immune system is down. It's rare, but it can happen. It can happen after a c-section ( me) or from something as simple as a tear from a vaginal delivery. I read the story of one lady who contracted it after a vaginal delivery who unfortunately passed away. You don't even need to have had surgery to get it- you can contract it through the tiniest cut you would never think twice about or a bruise. Once it hits, it progresses and kills rapidly. Survivors often lose organs or limbs and have extensive scarring. If you are at all curious about it http://www.nnff.org/facts.html has some good info as well as survivor stories. Maybe some day I will submit my own story.

In my case I didn't get it from MRSA which is something most people assume. I got it from a bacteria called Morganella morganii, which is commonly found in the intestinal track. When it shows up somewhere else it wreaks havoc. While it can be easily treated with the correct antibiotics it's resistant to most wide spectrum antibiotics so there is usually a delay in correct treatment. Usually, you see these infections postoperative settings. I had the bacteria in my uterus before the c-section. They have no clue how in the world it got there. Emily was born septic with the bacteria and they predicted I had it for at least a couple of weeks. There are only 2-3 other documented cases of newborns born with the bacteria and they did not fare so well. One baby even ended up getting necrotizing fasciitis because of it. That was honestly the hardest part of this whole ordeal for me: being told that my seemingly healthy newborn was septic with a incredibly dangerous bacteria that was often fatal for babies and handing her over to the NICU team not knowing what was going to happen. At that point we didn't even have a name for the bacteria yet as it would be several days before the culture came back. We just knew that it was a gram-negative rod and very dangerous. The doctors were cautiously optmisitic because Emily didn't seem sick yet and happily her spinal tap came back clear. They guessed at antibiotics and fortunately one of them half way worked and kept it at bay until the culture came back and they could put her on the right one. If their guess hadn't been half way right she would have died.

I fared worse than Emily did. The antibiotics they put me on didn't touch it and I developed necrotizing fasciitis. Like a lot of patients, I didn't realize this until I was conscious again. I was very lucky. Because I was already in the hospital and I had a wonderful team of doctors they were able to spot it quickly. I was in surgery within a few minutes of them receiving the CT results. Being pregnant was my saving grace in many respects. Because I was pregnant I had a lot of extra fascia and skin. They were able to close my fascia and my scarring is not nearly as bad as it would have otherwise been. Yes, my fascia is thin and I will have to have it reinforced in about 10 years but that is far preferable to having a mesh. My scarring isn't that bad. I have a typical c-section scar except mine goes from hip to hip and then it t's up to a few inches below my belly button. Then in the middle of it there is a 4 inch square pear shape where there wasn't enough skin to close. To put things in perspective I lost about 100 inches square of skin, but because I had been pregnant they were able to use the extra skin and gradually close most of it. Instead of scars taking up most of my abdomen I am just missing skin in a small pear shaped area under my c-section scar. No, you won't catch me in a bikini ( you wouldn't have anyway), but almost all of it would be covered by a pair of bathing suit bottoms actually. My uterus just has the typical low transverse incision so I am still free to attempt a v-bac if I have another baby.

Overall, I am incredibly fortunate to have fared so well with my brush with necrotizing fasciitis. I have little scarring all things considered and a bit of numbness in my lower abdomen, as well as one spot where I have absolutely no feeling. I didn't lose any organs ( my uterus was up in the air for awhile, but for some reason God spared it). I can live with the numbness and scarring and honestly it doesn't bother me at all.

Ack, I don't know how this entry ended up being on necrotizing fasciitis. I promise my next entry will be more cheerful and interesting.